Vet me if you like, but after a little browsing on the internet, I read that:

Only 9% of people are successful in keeping with their New Year's resolutions. Most people quit with the new year goals on the second Friday of the month. 43% of people are most likely to give up on their New Year's resolution by the month of February.

That’s part of the reason I was so happy to see Mel last week. Mel, age 56, came to the office for an injection of naltrexone, which she has done faithfully now each month for the last year.

A year ago, Mel was consuming a minimum of 2 bottles of wine daily and (per self-report) still performing well at work. She had several employees who reported to her as their regional sales manager and since she was able to mostly work from home, she felt like everything was under control.

Her anticipation and craving grew each day as 3 o’clock neared, when she opened a bottle of wine to allow it to breathe. She had a hard rule in place not to start drinking before 4:00 pm, which gave her a sense of feeling ‘in control’ of her alcohol consumption. She enjoyed the buzz of the first few drinks. Then she continued to drink to maintain the buzz, which was not particularly successful. As a single woman without children, she usually fell asleep in an overstuffed chair in front of the television around 11:00 pm and groggily went to bed around 1 or 2 in the morning.

Waking up in time for her first meetings wasn’t too hard; she oversaw scheduling them, so her colleagues were used to afternoon or late morning meetings via Zoom.

Risk of Long-Term Alcohol Consumption

Life was rolling along and even though Mel knew she was drinking too much, she was able to compartmentalize this thought, especially after she received a significant bonus and raise for her good work. She assumed many of her friends and colleagues were consuming similar amounts of alcohol, and they often sent each other humorous wine memes. She recognized that she was consuming fewer calories from actual food, forgetting chunks of conversations she had with her family and friends, and was somewhat embarrassed about her recycling, but it wasn’t until one of her best friends was diagnosed with liver failure that her wakeup call came.

Sal and Mel had been friends since college days. They were in each other’s weddings and Mel was Godmother to Sal’s daughter. They both climbed their respective career ladders and were each other’s support systems during their divorces. They started drinking in college and never stopped.

How Much Alcohol Is Safe to Drink?

I don’t know the amount of alcohol Sal was consuming, but both Sal and Mel are representative of the dramatic increase in alcohol consumption among women. According to a study cited by the National Institute on Alcohol Abuse and Alcoholism looking at alcohol use patterns in the United States from 2001 to 2002 compared with 2012 to 2013, there is an 80% increase in heavy alcohol consumption among women. Gender differences make women more susceptible than men to the detrimental effects of alcohol.

As defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), for women, low-risk drinking is no more than 3 drinks on any single day and no more than 7 drinks per week. For men, it is defined as no more than 4 drinks on any single day and no more than 14 drinks per week.

Interestingly, this week Canada came out with revised guidelines related to alcohol consumption, stating that no amount of alcohol is good for you and quoted Dr. Catherine Paradis, interim associate director of research at the Canadian Centre on Substance Use and Addiction, that consumption of even two drinks per week has been associated with an elevated risk of seven types of cancer, including breast and colon cancer, as well as cardiovascular disease.

Dr. Paradis, who was a co-chairwoman of the panel that developed the new guidelines, noted that the World Health Organization had recently declared that the harms associated with drinking alcohol had been “systematically evaluated over the years and are well documented” and that “when it comes to alcohol consumption, there is no safe amount that does not affect health.” (Source).

The internet is rampant with “evidence” that small amounts of alcohol may be beneficial to a person’s health. Our Canadian neighbors are clearly interpreting the ‘research’ differently and I can’t help but wonder if-and-how the giant alcohol companies will choose to respond and if the USA will revise its current, more lenient recommendations

In any case, Mel’s best friend, Sal, was put on a list for a liver transplant.

Shocked into the reality of the devastation alcohol had caused to her friend, Mel made herself a promise to quit drinking. On the day she made this decision, she told me she gave away 38 bottles of wine (some that had apparently cost her well over $100). That night she barely slept and experienced tremors and vomiting. Accurately worried that she had developed a physical dependence on alcohol, she called the Coleman Institute for Addiction Medicine and scheduled a detox. We were able to get her in the very next day, informing her it would be safer for her to consume enough alcohol to mitigate her symptoms before her arrival. Stopping alcohol abruptly can be dangerous.

Detox Treatment for Alcohol Addiction

At the Coleman Institute, we help people who want to safely stop drinking alcohol with a three day outpatient detox. This approach allows our patients to stay in the comfort of their homes, reducing stress and cost while increasing privacy and simplicity. Because we use medications that might cause drowsiness, we do require our clients to have a support person with them for the entire duration of treatment. Our patients are given medications that help with possible side effects and—importantly–reduce the risk of alcohol withdrawal seizures.

At the conclusion of the detox process, we prescribe both naltrexone and disulfiram (aka Antabuse) for most patients. I think of naltrexone as a medication that increases quality of life by helping to reduce the cravings for and enjoyment of alcohol. While it doesn’t make one sick to drink alcohol while taking naltrexone, it does seem to reduce the impulse to drink. I have had patients over the years tell me that while taking naltrexone they “could drive past a liquor store and it might as well have been a shoe store”, and “I could go out to eat and not be jonesing for the drink someone at the next table was having”.

Disulfiram is more of a deterrent medicine; drinking alcohol while taking it can cause uncomfortable flushing, nausea, and even vomiting. For those who are determined to stop drinking and feel they may be tempted, the disulfiram provides an extra layer of protection.

As far as keeping New Year’s resolutions or achieving any other goals, James Clear, author of Atomic Habits emphasizes the importance of creating identity-based habits; that one must decide what kind of a person one wants to be, and then prove it to oneself through small wins.

Mel took a big first step by reaching out to us, and each day for over a year now, she has worked to create habits consistent with her vision of herself as a non-drinker. For her this has meant hiring a sobriety coach, reading copious amounts of literature to have an almost encyclopedic knowledge of the way alcohol affects the human body physically, chemically, and emotionally, and by coming in monthly for Vivitrol injections.

If you are ready to think of yourself as a healthy person with healthy habits and want to drop the alcohol safely, please give us a call. We can tell you step-by-step what is involved. We would be honored to celebrate a one-year anniversary with you as well!

Take care,

Joan R. Shepherd, FNP